No advantage of Aβ42-lowering NSAIDs for prevention of Alzheimer dementia in six pooled cohort studies
Year: 2008
Type: article
Abstract: INTRODUCTION: Observational studies show reduced incidence of Alzheimer dementia (AD) in users of nonsteroidal anti-inflammatory drugs (NSAIDs). One hypothesis holds that the subset of NSAIDs known as selective A beta(42)-lowering agents (SALAs) is responsible for this apparent reduction in AD risk. METHODS: We pooled individual-level data from six prospective studies to obtain a sufficient sample to examine AD risk in users of SALA vs non-SALA NSAIDs. RESULTS: Of 13,499 initially dementia-free participants (70,863 person-years), 820 developed incident AD. Users of NSAIDs (29.6%) showed reduced risk of AD (adjusted hazard ratio [aHR] 0.77, 95% CI 0.65-0.91). The point estimates were similar for SALAs (aHR 0.87, CI 0.72-1.04) and non-SALAs (aHR 0.75, CI 0.56-1.01). Because 573 NSAID users (14.5%) reported taking both a SALA and non-SALA, we examined their use alone and in combination. Resulting aHRs were 0.82 (CI 0.67-0.99) for SALA only, 0.60 (CI 0.40-0.90) for non-SALA only, and 0.87 (CI 0.57-1.33) for both NSAIDs (Wald test for differences, p = 0.32). The 40.7% of participants who used aspirin also showed reduced risk of AD, even when they used no other NSAIDs (aHR 0.78, CI 0.66-0.92). By contrast, there was no association with use of acetaminophen (aHR 0.93, CI 0.76-1.13). CONCLUSIONS: In this pooled dataset, nonsteroidal anti-inflammatory drug (NSAID) use reduced the risk of Alzheimer dementia (AD). However, there was no apparent advantage in AD risk reduction for the subset of NSAIDs shown to selectively lower A beta(42), suggesting that all conventional NSAIDs including aspirin have a similar protective effect in humans.
Source: Neurology
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1004838280, G1023702118, G1220223050, G125972088, CORONARY HEART DISEASE AND STROKE, Risk Evaluation and Education for Alzheimer's Disease (REVEAL IV), CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, RISK FACTORS AND EARLY SIGNS IN ALZHEIMERS DISEASE/BLSA, CHS-ULTRASOUND READING, CORONARY HEART DISEASE AND STROKE, MRI READING CENTER FOR THE CARDIOVASCULAR HEALTH STUDY, G172097975, CORONARY HEART DISEASE AND STROKE IN PEOPLE AGED 65-84, G1964600565, G2194386449, CORONARY HEART DISEASE AND STROKE IN PEOPLE AGED 65-84, CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84, G2306943636, G23443890, G2391884931, G250621538, CORONARY HEART DISEASE &STROKE IN THE ELDERLY, G270907595, G277826483, G2800149121, G3036721468, G3045517347, G3176571579, Outcomes and Predictors in Mild Cognitive Impairment, G328935669, G34347772, Early Markers of Alzheimer Disease, CENTRAL BLOOD ANALYSIS LABORATORY FOR CHS, G4048755144, EPIDEMIOLOGY OF DEMENTIA: A PROSPECTIVE COMMUNITY STUDY, G423252844, G4454824495, G4523864531, G4617276643, G478075696, G485746134, Epidemiology of Dementia in Cache County, Utah, G5164707915, G581887176, CHS Events Follow-up Study, G6226795708, MRI, Genetics & Cognitive Precursors of AD and Dementia, The Framingham Heart Study, CHS-Transition Phase, Characterizing and Communicating Genetic Risk for Alzheimer's Disease, Patterns and Predictors of Normal Cognitive Aging, G7176672723, CHS RETINAL READING CENTER, Boston University Alzheimer's Disease Center, CARDIOVASCULAR HEALTH STUDY--ECHOCARDIOGRAPHY, G7814717484, G7999488110, Genetic Epidemiological Studies of Alzheimer Disease, G838824235, G8402048158, COGNITIVE TESTS, APOE, BRAIN MRI AND RISKS OF DEMENTIA, Trends in and Outcomes of Medication Use in Older Adults, G8593276544, Epidemiology of Dementia in the Framingham Study, G905887895
OpenAlex ID: W1981962503